Friday, June 30, 2006

Homocysteine, B-Vitamins and Heart Disease
The headlines say that a recent study proves ‘B-Vitamins don’t prevent heart attacks’, but these reports are highly misleading. In fact, it’s the homocysteine theory of heart disease that has been somewhat discredited by recent studies, but B-Vitamins are continually successful at lowering this inflammatory chemical and at reducing the number of non-fatal strokes. So why do news reports call B-Vitamins, which behaved exactly as predicted by previous studies, “ineffective”? It would be more accurate to apply that term to the medical theorists whose proposed link between homocysteine and heart disease deaths has now been challenged by these studies.
The real news is that homocysteine is probably not the strong predictor of heart disease that was previously suggested. In other words, while B-Vitamins and other nutrients do enhance the body’s energy production cycle and prevent the build up of homocysteine, homocysteine may not be a strong factor predicting deaths from heart disease in high-risk patients with preexisting conditions.
These B-Vitamins have been confirmed as significantly reducing levels of homocysteine (an undesirable, inflammatory chemical temporarily produced in the Citric Acid energy cycle) that can accumulate in the absence of certain essential B-Vitamins (folic acid, B6 and B12) and other nutrients known as methyl donors (found in the nutrients choline, TMG, DMG and SAM-e). This has been confirmed in the American Heart Journal report:
“BACKGROUND: Dietary supplementation with folic acid and vitamin B12 lowers blood homocysteine concentrations by about 25% to 30% in populations without routine folic acid fortification of food and by about 10% to 15% in populations with such fortification. In observational studies, 25% lower homocysteine has been associated with about 10% less coronary heart disease (CHD) and about 20% less stroke.
CONCLUSION: The strength of association of homocysteine with risk of cardiovascular disease may be weaker than had previously been believed.”
So it's really the medical hypothesis linking homocysteine to deaths from heart disease that is being questioned by these studies, not the efficacy of the vitamins to lower homocysteine. The news stories suggesting that the B-Vitamins somehow failed are extremely misleading and do not accurately represent the data. This is a hauntingly familiar scenario. Somehow, vitamins get a lot of undeserved bad press, completely out of context from the details of the studies.
Something is seriously wrong with our system of reporting about science when factually deficient reports are so often generated without being seriously questioned by medical experts. The public is given a false sense of what a study means, with dietary supplements frequently singled out as being harmful or useless (or both!), even when these accusations are not supported by good data.
There is an understandable tendency for the media to embrace controversial stories, contributing to an environment where one single study is touted as negating every other study that has ever been done. But sometimes that one study is poorly designed, or gets inaccurately represented in the press (low fat diets, anyone?). It is understandable why such provocative reports get wide coverage, but not why the subsequent criticism of the studies doesn’t. This only leads to public confusion about supplements, diets, etc., which leads to a growing mistrust by the public of how reliable are media reports on nutrition topics.
No wonder people are so confused about nutrition and diet, when even scientists can’t figure out how to study and report on these topics accurately! The sensational headlines and stories promoting controversial – and often contradictory - science reports have far more impact than the rare correction or follow-up report.
Neil E. LevinCertified Clinical NutritionistDiplomate in Advanced Nutritional Laboratory AssessmentBloomingdale, IL 3/16/2006
Neil E. Levin is a certified clinical nutritionist and is a professional member of the International & American Associations of Clinical Nutritionists.
Neil is a member of the Scientific Council of the national Clinical Nutrition Certification Board and has a Diplomate in Advanced Nutritional Laboratory Assessment.
He is on the Board of Directors of the Mid-American Health Organization (MAHO), the Midwest regional affiliate of the National Nutritional Foods Association (NNFA).
Neil has published many articles in magazines and newspapers, and has appeared numerous times on radio and television news programs.
Neil is also the president of Nutrition for Optimal Health Association, Inc. (http://www.nutrition4health.org/), a not-for-profit nutrition education corporation based in Winnetka, Illinois.
REFERENCES:
B-Vitamin Treatment Trialists' Collaboration. Homocysteine-lowering trials for prevention of cardiovascular events: a review of the design and power of the large randomized trials. Am Heart J. 2006 Feb;151(2):282-7. Review. PMID: 16442889
Lonn E, et al. Rationale, design and baseline characteristics of a large, simple, randomized trial of combined folic acid and vitamins B6 and B12 in high-risk patients: the Heart Outcomes Prevention Evaluation (HOPE)-2 trial. Can J Cardiol. 2006 Jan;22(1):47-53. PMID: 16450017
Bonaa KH, et al. Homocysteine Lowering and Cardiovascular Events after Acute Myocardial Infarction. N Engl J Med. 2006 Mar 12; [Epub ahead of print] PMID: 16531614

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About Me

Neil E. Levin, CCN, DANLA is a nationally board-certified clinical nutritionist with a Diplomate in Advanced Nutritional Laboratory Assessment. He is a professional member of the International & American Associations of Clinical Nutritionists.
Neil is a nutrition educator and a dietary supplement formulator.
Neil is a member of the Scientific Council of the national Clinical Nutrition Certification Board and is on the board of directors of the Mid-American Health Organization (MAHO), the Midwest regional affiliate of the National Products Association (NPA). In July, 2008, Neil was named an NPA Industry Champion, "an award given to people who have made notable individual contributions to industry above and beyond what is expected to achieve commercial success".
Neil is the immediate past president and Program Chair of the American Nutrition Association (americannutritionassociation.org).
Neil is frequently published or quoted in magazines, newspapers, and scientific journals and has been on numerous radio and television news programs. Follow me on Twitter: neilelevin